The overall goal of this protocol is to define the link between insulin resistance and coronary heart disease (CHD). During the past year we have obtained evidence that mononuclear cells isolated from insulin resistant patients with non-insulin-dependent diabetes mellitus bind with greater avidity to cultured endothelial cells. Since this defect is among the earliest steps in the process of atherogenesis, these data provide a possible mechanistic explanation for why risk of CHD is increased in insulin resistant individuals.